A gender and culturally specific approach to reduce NAFLD in Mexican American men

减少墨西哥裔美国男性 NAFLD 的性别和文化特定方法

• 批准号: 10307086
• 负责人: David O. Garcia
• 金额: $ 13.33万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-07 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10307086
• 关键词: Adherence; Affect; Alleles; Arizona; Attitude; Behavior; Belief; Body Weight; Body Weight decreased; Body mass index; Categories; Characteristics; Consumption; Counseling; County; Data; Data Set; Development; Diet; Dietary Sugars; Disclosure; Disease; Disease Management; Environment; Evaluation; FDA approved; Fatty acid glycerol esters; Foundations; Frequencies; Gender; Genes; Genetic; Genetic Predisposition to Disease; Genotype; Goals; Guidelines; Health; Health behavior; Hispanic; Incidence; Intervention; Interview; Knowledge; Life Style; Life Style Modification; Literature; Liver; Mentored Research Scientist Development Award; Mentors; Mentorship; Metabolic; Methodology; Mexican Americans; Modeling; Monitor; National Institute on Minority Health and Health Disparities; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Obesity associated cancer; Obesity associated disease; Outcome; Participant; Pathogenicity; Pathway interactions; Pharmacologic Substance; Phenotype; Phospholipase; Physical activity; Play; Population; Positioning Attribute; Precancerous Conditions; Predisposition; Prevention therapy; Primary carcinoma of the liver cells; Proteins; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Resources; Risk; Risk Factors; Role; Severities; Structure; Subgroup; Therapeutic Intervention; Time; Training; Universities; Weight maintenance regimen; Work; behavior change; black men; burden of illness; cancer risk; cardiometabolism; career; carrier status; cohort; design; diabetes prevention program; dietary; disorder risk; elastography; high risk; high risk population; imaging biomarker; improved; intervention delivery; lifestyle intervention; male; men; non-alcoholic fatty liver disease; non-invasive imaging; obese person; patient engagement; physical inactivity; programs; recruit; risk variant; satisfaction; skill acquisition; skills; social culture; statistics; stem; sugar; sweetened beverage; therapeutically effective; therapy design; weight loss intervention

ABSTRACT Effective therapeutic interventions are needed to stem the alarming increases in non-alcoholic fatty liver disease (NAFLD) in Mexican-American men, an understudied population at greater risk for the development of hepatocellular carcinoma (HCC). Primary lifestyle risk factors for NAFLD include physical inactivity and sugar- sweetened beverage consumption, characteristics that are highly evidenced in Mexican-American men. The risk of NAFLD is further increased in Mexican-American men by a greater frequency (up to 55%) of the risk allele at the PNPLA3 (patatin-like phospholipase domain-containing protein) gene. This allele confers a substantially greater susceptibility to NAFLD and HCC. In the absence of FDA-approved pharmaceutical agents, lifestyle modification, including weight loss initiated by improvements in dietary and physical activity behavior, is the recommended therapy for the prevention and treatment of NAFLD. Lifestyle interventions targeting modest weight loss (approximately 5% body weight) have been shown to result in significant reductions in liver fat. However, evidence regarding the effects of a lifestyle intervention designed exclusively for Mexican-American men at greater risk for NAFLD is not currently available. Dr. David Garcia has an excellent foundation in lifestyle interventions that has positioned him well to advance toward his goal of reducing obesity-related disease burden in Mexican-American males. The goal of this NIMHD K01 Mentored Research Scientist Development Award is to provide Dr. Garcia with an in-depth understanding of metabolic and pathogenic pathways and risk factors of obesity-related cancers and related diseases, with a specific focus on NAFLD and HCC in Mexican-American men. He also will gain training in non-invasive imaging biomarkers (e.g., transient elastography) for the evaluation and management of disease state and risk factors. Lastly, he will advance his knowledge and skill development in research methodologies (e.g., quantitative analysis and qualitative inquiry) that informs on the design and tailoring of a culturally-specific study to reduce the burden of NAFLD. With the mentorship of Dr. Cynthia Thomson and Dr. Michael Fallon, co-mentors, and collaborators; for the proposed project Dr. Garcia intends to 1) use an available dataset from the Cameron County Hispanic Cohort (CCHC) to assess risk for NAFLD, including the influence of phenotypic factors (lifestyle behaviors) in Mexican-American men; 2) evaluate the knowledge, attitudes, and beliefs of obesity-related cancer risk, with an emphasis on NAFLD and HCC risk in Mexican-American men; and 3) assess the feasibility, acceptability, and preliminary efficacy of a NAFLD-specific weight loss intervention tailored for Mexican-American men. The training plan and research strategy in this K01 application will afford Dr. Garcia the time, resources, and mentorship necessary to achieve his career goal which is enthusiastically endorsed by University of Arizona leaders and an extremely appropriate and supportive research environment.

抽象的 需要有效的治疗干预措施来阻止非酒精脂肪肝的惊人增加 墨西哥裔美国人的疾病（NAFLD），这是一个研究的人口，对发展的风险更大 肝细胞癌（HCC）。 NAFLD的主要生活方式危险因素包括身体不活跃和糖 - 甜饮料消耗，墨西哥裔美国人高度证明的特征。这 墨西哥裔美国人的风险进一步增加了风险的频率（最高55％） PNPLA3（Patatin样磷脂酶结构域）基因的等位基因。这个等位基因赋予 对NAFLD和HCC的敏感性大大更大。在没有FDA批准的药物的情况下 代理商，生活方式的改变，包括通过饮食和体育锻炼的改善引发的体重减轻 行为是预防和治疗NAFLD的推荐疗法。生活方式干预措施 靶向适中的体重减轻（大约5％体重）已显示出显着的 减少肝脂肪。但是，有关专门设计生活方式干预效果的证据 对于墨西哥裔美国人而言，目前尚不可用的NAFLD风险更大。大卫·加西亚博士有一个 生活方式干预措施的良好基础，使他能够朝着他的目标迈进 减轻墨西哥裔美国男性与肥胖相关的疾病负担。这个NIMHD K01的目标 研究科学家发展奖是为了向加西亚博士提供对代谢的深入了解 以及肥胖相关癌症和相关疾病的致病途径和风险因素，并具有特定的重点 在墨西哥裔美国人的NAFLD和HCC上。他还将获得非侵入性成像生物标志物的培训 （例如，瞬态弹性图）用于评估和管理疾病状态和危险因素。最后，他 将提高他在研究方法中的知识和技能发展（例如，定量分析和 定性询问）介绍了一项特定于文化研究的设计和剪裁，以减轻负担 nafld。在辛西娅·汤姆森（Cynthia Thomson）博士和合作社迈克尔·法伦（Michael Fallon）博士的指导下； 对于拟议的项目，Garcia博士打算1）使用卡梅伦县西班牙裔的可用数据集 队列（CCHC）评估NAFLD的风险，包括表型因素（生活方式行为）的影响 墨西哥裔美国人； 2）评估与肥胖相关癌症风险的知识，态度和信念 强调墨西哥裔美国人的NAFLD和HCC风险； 3）评估可行性，可接受性， 以及针对墨西哥裔美国人量身定制的NAFLD特异性减肥干预措施的初步功效。这 该K01申请中的培训计划和研究策略将为Garcia博士提供时间，资源和 实现他的职业目标所必需的指导，亚利桑那大学热情地认可 领导者和极其适当和支持性的研究环境。